| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 16404 N BLACK CANYON HWY STE 140 PHOENIX, AZ 85009 | REGENCE BLUE SHIELD | $53K | $2K | $55K | 4.36% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | REGENCE BLUE SHIELD | $5K | — | $5K | 0.41% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DR ROCHESTER, NY 14620 | STARMOUNT LIFE INSURANCE COMPANY | $7K | $7K | $14K | 18.56% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | STARMOUNT LIFE INSURANCE COMPANY | $744 | — | $744 | 0.99% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY, INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 14.04% |
| MADDOCK & ASSOCIATES LLC3 | 1407 WILLOW ROAD EAST SUITE C FIFE, WA 98424 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $380 | — | $380 | 1.10% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUE SHIELD | 124 | $1.3M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 103 | $75K |
| Vision | REGENCE BLUE SHIELD | 124 | $1.3M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $34K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $34K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $34K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.